Monday, September 30, 2013

Why I love Obamacare

I think most people who hate Obamacare probably always got
their health insurance through their employer.They have no idea what the individual health insurance market has been
like.Once I didn’t know.I know now.That’s why I love Obamacare.

In 1992, I left a consulting company to do what I wanted to
do with my life.I had already written
and published three books—Maximum
Performance Management, Workplace 2000, and The Competitive Edge.I had
signed a contract to write a book about IBM with a group of executives at IBM
which became The Quality Journey.Originally, I had planned to take a leave of
absence to write The Quality Journey
but decided that instead of returning to the consulting company, I would go out
on my own to speak, consult on management and leadership and, most importantly,
do the thing I had always wanted to do—write books.Since then, I’ve written twelve other books,
consulted with hundreds of companies and traveled as far as Australia to give speeches
on management and leadership.

Before I went out on my own, I had never given much thought
to health insurance.My wife Jimmie and
I had always gotten health insurance for ourselves and our family through our
employers.For the most part, we were
very healthy.With the exception of an
occasional bout of the flu, a sprained ankle or broken bone, we rarely saw a
doctor.Therefore, we were surprised in
the early 1990s when we started trying to buy health insurance in the
individual market.We had been
accustomed to just picking between a number of health insurance plans our
employers offered.There were no questions
to answer about our health or any pre-existing condition. We looked through the
plans and just picked what we liked.

The individual market was totally different.No insurer would issue a policy or even tell
us what it would cost until we answered hundreds of questions—often very
intrusive questions—about our health histories and our parent’s health.Often, we would have to repeat our answers
during long telephone calls where a employee of the insurance company, usually
who barely spoke English, quizzed us about all of our answers.One wanted to know if my wife had ever been
diagnosed with de-app-tades.We finally
figured out that the person on the line was asking about a diagnosis of
diabetes. She just couldn't pronounce the word. My wife said NO.We had to go through this process every few
years because every year our premium would increase, usually by double
digits and we would be forced to look for more affordable coverage.Every year we would pay more for
policies that provided fewer benefits and required higher co-pays and
deductibles.At one point, considering
out-of-pocket costs, premiums, and deductibles, we had to spend close to
$30,000 in any given twelve month period BEFORE our insurance company picked up
one dime of the cost of our medical care.We had never gone to doctors often.Now we went even less often, fearing that a doctor would prescribe or
recommend some treatment for something like high blood pressure, cholesterol,
or something else our health insurance provider could use as an excuse to drop
our coverage, jack up our premiums, or deny us coverage due to our
“pre-existing condition.”I remember
pleading with my doctor at one point to perform another test when the original
test result turned up an indication that I might have something that would mean
I couldn’t get or keep my health insurance.Fortunately, the second test turned out normal.However, it was a scary week or two.

As my wife and I got older, getting health insurance, any
kind at any cost from any health insurance company on the individual market,
became harder and harder.We would
apply, go through the long process of answering questions and then be turned
down for coverage and/or offered coverage that excluded just about any sickness
or condition a person of our ages might have.We could get health insurance as long as heart disease, cancer, and so
on and so on were excluded.Once I got a
good quote for a policy from a insurance agent.The premium was so good compared to everything else I had seen that I
asked to see the actual policy.At first
he didn’t want to send it too me but finally did.I learned why he didn’t want me to see it.I spent three days reading the pages and
pages of fine print.Fortunately, I knew
how to read legal documents from my consulting.I mapped out the coverage and discovered that the policy covered a very
limited number of conditions and then only while we were hospitalized and then
only for a very limited number of days.The insurance was very attractively packaged and the price was very
good.However the devil was in the
details and the details were terrible.That policy was next to worthless if you got any serious illness or
really any illness at all.It was
entirely legal for this insurance company to sell me a worthless policy since
we lived in Georgia and there were few restrictions in Georgia on what kind of
junk policies health insurance companies could sell.

My wife and I have experience with just about all of the
different ways an American could get health insurance—through their employer,
on the individual market and now Medicare.The individual market was by far the worst.Fortunately, our income was such that we
could afford to carry high deductibles.Fortunately, we were healthy enough that we never got a “pre-existing
condition” that would have made getting coverage impossible.Fortunately, we both have advanced degrees
and experience doing research, so we knew how to read between the lines and
protect ourselves from shyster insurance agents and companies.I don’t know what other people with less
income and less education and training and/or who had a pre-existing condition
did about getting health insurance.Wait, I know.They went without
insurance.When they got sick, the
coped.When they got seriously sick they
went bankrupt trying to pay their medical bills.Some died because they couldn’t get access to
health care they could afford.Some
people we knew stayed in jobs they hated, terrified that they might lose their
jobs and their health insurance coverage, knowing that they would not be able
to get health insurance on the individual market because they or a family
member was seriously ill—i.e., had a “pre-existing condition.”

Obamacare changes everything.After January, most Americans who need to get
health insurance on the individual market will be able to get good coverage at
a reasonable cost.And, people who
decide that they want to pursue their dream and start their own business doing
what they love, like I did, will be able to do so without worrying about
getting health insurance.

And, you tell me Obamacare is a BAD THING.Walk a mile in the health insurance shoes my
wife and I wore before we could get Medicare.